哮喘的不同表型：临床发现和实验动物模型
2021/10/20
摘要
哮喘是一种呼吸道过敏性疾病，在世界范围内发病率很高，它是包括死亡在内的多种并发症的始作俑者。幸运的是，哮喘不再被认为是一种独特的表现，而是一种非常异质的表现。它的表型和内型分别被认为是病理和分子特征，它们之间可能没有直接联系。越来越多的研究涉及这一问题，带来了越来越深入的理解和认识。本综述旨在总结临床研究中获得的新信息，这些信息不仅允许通过个性化药物和更深入的分子评估创建患者群体，而且还与从实验模型，特别是小鼠模型中获得的数据建立了联系。我们收集了有关致敏和诱因的以及强调了最相关的表型和内型（如高Th2哮喘和低Th2哮喘）的信息，其中包括吸烟和肥胖相关哮喘以及混合性和寡细胞性哮喘，不仅在生理病理学和临床上，而且在如何使用小鼠模型以相对相似性确定这些表型方面。我们还进一步调查了临床研究是如何使用新开发的药物治疗患者的，而这些药物侧重于与患者临床表现更相关的特定生物标记物。
Different Phenotypes in Asthma: Clinical Findings and Experimental Animal Models
Luiz Otávio Lourenço, Alessandra Mussi Ribeiro, Fernanda Degobbi Tenório Quirino Dos Santos Lopes, Iolanda de Fátima Lopes Calvo Tibério, Wothan Tavares-de-Lima, Carla Máximo Prado
Abstract
Asthma is a respiratory allergic disease presenting a high prevalence worldwide, and it is responsible for several complications throughout life, including death. Fortunately, asthma is no longer recognized as a unique manifestation but as a very heterogenic manifestation. Its phenotypes and endotypes are known, respectively, as pathologic and molecular features that might not be directly associated with each other. The increasing number of studies covering this issue has brought significant insights and knowledge that are constantly expanding. In this review, we intended to summarize this new information obtained from clinical studies, which not only allowed for the creation of patient clusters by means of personalized medicine and a deeper molecular evaluation, but also created a connection with data obtained from experimental models, especially murine models. We gathered information regarding sensitization and trigger and emphasizing the most relevant phenotypes and endotypes, such as Th2-high asthma and Th2-low asthma, which included smoking and obesity-related asthma and mixed and paucigranulocytic asthma, not only in physiopathology and the clinic but also in how these phenotypes can be determined with relative similarity using murine models. We also further investigated how clinical studies have been treating patients using newly developed drugs focusing on specific biomarkers that are more relevant according to the patient's clinical manifestation of the disease.
哮喘是一种呼吸道过敏性疾病，在世界范围内发病率很高，它是包括死亡在内的多种并发症的始作俑者。幸运的是，哮喘不再被认为是一种独特的表现，而是一种非常异质的表现。它的表型和内型分别被认为是病理和分子特征，它们之间可能没有直接联系。越来越多的研究涉及这一问题，带来了越来越深入的理解和认识。本综述旨在总结临床研究中获得的新信息，这些信息不仅允许通过个性化药物和更深入的分子评估创建患者群体，而且还与从实验模型，特别是小鼠模型中获得的数据建立了联系。我们收集了有关致敏和诱因的以及强调了最相关的表型和内型（如高Th2哮喘和低Th2哮喘）的信息，其中包括吸烟和肥胖相关哮喘以及混合性和寡细胞性哮喘，不仅在生理病理学和临床上，而且在如何使用小鼠模型以相对相似性确定这些表型方面。我们还进一步调查了临床研究是如何使用新开发的药物治疗患者的，而这些药物侧重于与患者临床表现更相关的特定生物标记物。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Clin Rev Allergy Immunol. 2021 Sep 20. doi: 10.1007/s12016-021-08894-x.)
(Clin Rev Allergy Immunol. 2021 Sep 20. doi: 10.1007/s12016-021-08894-x.)
Different Phenotypes in Asthma: Clinical Findings and Experimental Animal Models
Luiz Otávio Lourenço, Alessandra Mussi Ribeiro, Fernanda Degobbi Tenório Quirino Dos Santos Lopes, Iolanda de Fátima Lopes Calvo Tibério, Wothan Tavares-de-Lima, Carla Máximo Prado
Abstract
Asthma is a respiratory allergic disease presenting a high prevalence worldwide, and it is responsible for several complications throughout life, including death. Fortunately, asthma is no longer recognized as a unique manifestation but as a very heterogenic manifestation. Its phenotypes and endotypes are known, respectively, as pathologic and molecular features that might not be directly associated with each other. The increasing number of studies covering this issue has brought significant insights and knowledge that are constantly expanding. In this review, we intended to summarize this new information obtained from clinical studies, which not only allowed for the creation of patient clusters by means of personalized medicine and a deeper molecular evaluation, but also created a connection with data obtained from experimental models, especially murine models. We gathered information regarding sensitization and trigger and emphasizing the most relevant phenotypes and endotypes, such as Th2-high asthma and Th2-low asthma, which included smoking and obesity-related asthma and mixed and paucigranulocytic asthma, not only in physiopathology and the clinic but also in how these phenotypes can be determined with relative similarity using murine models. We also further investigated how clinical studies have been treating patients using newly developed drugs focusing on specific biomarkers that are more relevant according to the patient's clinical manifestation of the disease.
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大规模激发研究发现，对普遍存在的空气过敏原适应不良与严重过敏性鼻结膜炎及哮喘相关
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体力活动在哮喘学龄前儿童哮喘控制中的作用及其免疫调节作用
